Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2017 Oct;47(13):2260-2274.
doi: 10.1017/S0033291717000708. Epub 2017 Apr 7.

Posttraumatic stress disorder in the World Mental Health Surveys

K C Koenen  1 , A Ratanatharathorn  2 , L Ng  3 , K A McLaughlin  4 , E J Bromet  5 , D J Stein  6 , E G Karam  7 , A Meron Ruscio  8 , C Benjet  9 , K Scott  10 , L Atwoli  11 , M Petukhova  12 , C C W Lim  10 , S Aguilar-Gaxiola  13 , A Al-Hamzawi  14 , J Alonso  15 , B Bunting  16 , M Ciutan  17 , G de Girolamo  18 , L Degenhardt  19 , O Gureje  20 , J M Haro  21 , Y Huang  22 , N Kawakami  23 , S Lee  24 , F Navarro-Mateu  25 , B-E Pennell  26 , M Piazza  27 , N Sampson  12 , M Ten Have  28 , Y Torres  29 , M C Viana  30 , D Williams  31 , M Xavier  32 , R C Kessler  12
Affiliations
Multicenter Study

Posttraumatic stress disorder in the World Mental Health Surveys

K C Koenen et al. Psychol Med. 2017 Oct.

Abstract

Background: Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking.

Methods: Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics.

Results: The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed.

Conclusions: PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.

Keywords: Epidemiology; International; Posttraumatic stress disorder (PTSD); trauma; treatment.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Age of onset distributions of DSM-IV posttraumatic stress disorder by income-group countries.
Fig. 2
Fig. 2
Percentage of respondents reporting specialty mental health treatment by country income level.
See this image and copyright information in PMC

References

    1. Alhasnawi S, Sadik S, Rasheed M, Baban A, Al-Alak MM, Othman AY, Othman Y, Ismet N, Shawani O, Murthy S, Aljadiry M, Chatterji S, Al-Gasseer N, Streel E, Naidoo N, Mahomoud Ali M, Gruber MJ, Petukhova M, Sampson NA, Kessler RC. The prevalence and correlates of DSM-IV disorders in the Iraq Mental Health Survey (IMHS) World Psychiatry. 2009;8:97–109. - PMC - PubMed
    1. Andrews B, Brewin CR, Rose S, Kirk M. Predicting PTSD symptoms in victims of violent crime: the role of shame, anger, and childhood abuse. Journal of Abnormal Psychology. 2000;109:69–73. - PubMed
    1. Atwoli L, Stein DJ, Koenen KC, Mclaughlin KA. Epidemiology of posttraumatic stress disorder: prevalence, correlates and consequences. Current Opinion in Psychiatry. 2015;28:307. - PMC - PubMed
    1. Atwoli L, Stein DJ, Williams DR, Mclaughlin KA, Petukhova M, Kessler RC, Koenen KC. Traumaand posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study. BMC Psychiatry. 2013;13:1. - PMC - PubMed
    1. Bangasser DA, Valentino RJ. Sex differences in stress-related psychiatric disorders: neurobiological perspectives. Frontiers in Neuroendocrinology. 2014;35:303–319. - PMC - PubMed

Publication types

MeSH terms